Anticoagulation on Warfarin Weakens After 6 Months

I was only on it for 6 months and I hated having to get the blood tests. When are they going to get to needle free blood draws?

Anticoagulation on Warfarin Weakens After 6 Months

Smart Tattoo Monitors Health

Could this be used along Needle free blood draws or microneedles to monitor INR for warfarin use instead of having to come in for blood draws? We'll never know with our incompetent stroke leadership. 

Smart Tattoo Monitors Health 

Checking vital health statistics may someday be as simple as shinning a light on a tattoo.
A group of researchers from Harvard Medical School (HMS) and the Massachusetts Institute of Technology (MIT) have developed a smart tattoo ink that changes color to signal changes in various biomarkers, including if an athlete is dehydrated or if a diabetic’s blood sugar rises.
The researchers paired biosensitive inks with traditional tattoo artistry as a way to overcome some of the limitations of biomedical monitoring devices that currently do not seamlessly integrate with the body.
“We were thinking: New technologies, what is the next generation after wearables?” Ali Yetisen, who is a Tosteson postdoctoral fellow at HMS and Massachusetts General Hospital, said in a statement. “And so we came up with the idea that we could incorporate biosensors in the skin.”
The stabilizing ink does not fade or diffuse into surrounding tissue and only changes color according to the chemistry of the body’s interstitial fluid—which can be used as a surrogate for constituents of the blood.
The researchers developed a pair of inks that signify glucose concentration and sodium concentration.
The first ink will change from green to brown as glucose concentration increases, while the second ink grows a more intense green color when viewed under a blue light as sodium concentration rises, an indication of dehydration.
To test the inks, the researchers tattooed segments of pig skin and found the changes in color or intensity in response to different biomarkers.
The next step will be to test the tattoos with other diseases and biomarkers.
The researchers said a long-lasting tattoo could be used to monitor chronic conditions or a temporary design could be used for shorter-duration monitoring.
The ink can also be invisible and only viewable under certain kinds of light that may be available through a smartphone application.    

Sleep and Human Aging

What is your doctors sleep protocol doing to ensure you get your beauty sleep while in the hospital?  I got woken up almost every morning by the blood vampires coming for either me or my roommates at 7am.  Do they now know about needleless blood draws, only out since May 2016? Needle free blood draws or microneedles?
I only copied the abstract and the conclusion paragraphs so there is lots more at the link.
http://www.cell.com/neuron/fulltext/S0896-6273%2817%2930088-0

Older adults do not sleep as well as younger adults. Why? What alterations in sleep quantity and quality occur as we age, and are there functional consequences? What are the underlying neural mechanisms that explain age-related sleep disruption? This review tackles these questions. First, we describe canonical changes in human sleep quantity and quality in cognitively normal older adults. Second, we explore the underlying neurobiological mechanisms that may account for these human sleep alterations. Third, we consider the functional consequences of age-related sleep disruption, focusing on memory impairment as an exemplar. We conclude with a discussion of a still-debated question: do older adults simply need less sleep, or rather, are they unable to generate the sleep that they still need?

Main Text

Normative aging is associated with a reduced ability to initiate and maintain sleep. Moreover, deficits in sleep physiology, including those of non-rapid eye movement (NREM) sleep and its associated neural oscillations, are especially prominent in later life. Though sleep disruption is a common signature of “normal aging”, the underlying neural mechanisms explaining age-related sleep impairment are only now being revealed.

This review focuses on physiological changes associated with normative human aging. First, we characterize associated alterations in sleep structure and oscillatory activity in later life. Second, we describe emerging neurobiological mechanisms that may account for these sleep alterations. Third, we consider the functional consequences of age-related sleep disruption, focusing on memory impairment. We conclude with the exploration of a still-unresolved question: are older adults unable to generate the sleep that they need or do they simply need sleep less.

S

Sleep Restoration, Aging, and Memory

The vast majority of studies reporting an association between sleep, aging, and memory are correlational in nature. However, several studies have sought to enhance the sleep of older adults, and with it, memory. These studies are informative in at least two ways. First, they establish a causal contribution of sleep to memory in the elderly, as has been shown in young adults. Second, therapeutic interventions that restore sleep may deliver preventative benefits that reduce the risk and/or severity of cognitive decline in aging, or mechanisms and/or processes that lead to mild cognitive impairment or Alzheimer’s disease (Mander et al., 2016a), or body ill-health consequences, such as hypertension or chronic pain (Neikrug and Ancoli-Israel, 2010). However, it is important to note that these methods have not been investigated using longitudinal study designs, and thus the longitudinal utility of such methods remains unknown.

In young adults, transcranial direct current stimulation (tDCS) in the <1 Hz slow oscillation frequency range during slow wave sleep increases slow oscillation power and almost doubles overnight memory retention (Marshall et al., 2006). In older adults, multiple studies have shown that enhancing the slow oscillation using tDCS during an afternoon nap leads to a memory enhancement; one showing heightened SWA in the slow oscillation frequency range (<1 Hz) and word-pair performance (Westerberg et al., 2015), and another showing enhanced slow oscillation and fast sleep spindle EEG power that led to a benefit in a visual memory task (Ladenbauer et al., 2016). Auditory closed-loop stimulation during slow wave sleep has also been shown to enhance slow oscillation power and associated hippocampus-dependent memory consolidation in young adults (Ngo et al., 2013). Preliminary findings in older adults have reported increased slow oscillation power during blocks of auditory stimulation that is associated with enhanced next-day declarative memory recall (Papalambros et al., 2017). It is of note, however, that some studies implementing varied forms of brain stimulation have failed to replicate the beneficial enhancement of sleep physiology and/or memory consolidation (Eggert et al., 2013, Passmann et al., 2016, Sahlem et al., 2015). Therefore, brain stimulation methods offer potential promise as intervention tools in the context of aging, but they require further refinement and demonstration of efficacy and reproducibility before being realistic options at present.

Pharmacological methods using classic GABA-targeting hypnotics for selective NREM sleep enhancement have so far proved less promising in the context of aging and often fail to trigger any corresponding sleep-dependent memory benefit in the elderly, sometimes even causing amnestic effects (Feld et al., 2013, Hall-Porter et al., 2014, Mednick et al., 2013, Vienne et al., 2012). Little is currently known regarding the impact of more contemporary non-GABA-targeting sleep medications on enhancing sleep and/or cognition in the elderly populations at risk for dementia.

Overall, several novel, non-pharmacological approaches are emerging that may represent candidate methods for sleep restoration in the elderly and, with such restoration, improvements in those mental and physical functions that rely on sleep and are causally deficient in the elderly as a result.

Fluctuations in “bad” cholesterol may be linked to worse brain health

How would your doctor even know if this is happening to you? While INR testing does not necessarily require fasting anymore, I'm sure frequent blood draws for this would not be covered by insurance. Unless the needle free blood draws come into practice soon.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=166067&CultureCode=en
Greater fluctuations in “bad” cholesterol levels may be linked to worse cognitive function in elderly adults, according to new research in the American Heart Association’s journal Circulation.
In a study of European adults age 70 to 82 years old, researchers found that greater fluctuations in low-density lipoprotein cholesterol (LDL), or “bad” cholesterol, are associated with lower cognitive performance.
For example, study participants with the highest LDL cholesterol variability took 2.7 seconds longer on average to finish a cognitive test to name ink colors of color words written in different ink (for example, the word blue written in red ink), compared to individuals with the lowest variability.
“While this might seem like a small effect, it is significant at a population level,” said Roelof Smit, M.D., lead study author and a Ph.D. student at Leiden University Medical Center in Leiden, the Netherlands.
The link between variability and declining cognitive function was found regardless of average bad cholesterol levels or use of cholesterol-lowering statin drugs.
In addition, greater fluctuations in bad cholesterol were associated with lower brain blood flow and greater white matter hyperintensity load - which has been linked to endothelialdysfunction.
These results show LDL cholesterol variability may be important to neurocognitive function, Smit said.
“Our findings suggest for the first time that it’s not just the average level of your LDL-cholesterol that is related to brain health, but also how much your levels vary from one measurement to another,” Smit said.
Measurements fluctuate because of diet, exercise, frequency of cholesterol-lowering statins and other factors, he said. However, these fluctuations might also reflect an increasingly impaired homeostasis; for example, due to age or underlying disease, added J.Wouter Jukema, M.D., Ph.D., senior author of the study and professor of Cardiology at the Leiden University Medical Center.
The research involved 4,428 participants from Scotland, Ireland and the Netherlands in the PROspective Study of Pravastatin in the Elderly at Risk. PROSPER participants either had preexisting vascular disease or were at a higher risk for developing the condition because of histories of hypertension, cigarette smoking or diabetes.
Researchers examined associations between LDL cholesterol variability and four cognitive measures: color-word test for selective attention, letter-digit coding to assess information processing speed and picture-word learning to test verbal memory in two ways – immediate recall and delayed recall after 20 minutes.
Although the research population was European, the results may be applicable to Americans as their lifestyle patterns predispose them to the same set of clinical outcomes, Smit said. But the results cannot be extrapolated directly to the general U.S. population because the study participants were older adults at high risk for vascular disease.
“These results add an important puzzle piece to the emerging evidence that vascular risk factors are closely related to brain health,” Smit said.  “Our study is just the first exciting step. Further studies are needed to examine whether these findings could truly influence clinical practice.”
http://newsroom.heart.org/news/fluctuations-in-bad-cholesterol-may-be-linked-to-worse-brain-health?preview=c778cef4bfb05954aef5021158d0a591

• Full bibliographic informationStella Trompet, Ph.D.; Behnam Sabayan, M.D., Ph.D.; Saskia le Cessie, Ph.D.; Jeroen van der Grond, Ph.D.; Mark van Buchem, M.D., Ph.D.; Anton de Craen, Ph.D.; and J. Wouter Jukema, M.D., Ph.D. Author disclosures are on the manuscript.; Higher Visit-to-Visit Low-Density Lipoprotein Cholesterol Variability Is Associated With Lower Cognitive Performance, Lower Cerebral Blood Flow, and Greater White Matter Hyperintensity Load in Older Subjects; DOI: 10.1161/CIRCULATIONAHA.115.020627

Velano Vascular needle-free blood draw device

How long before your hospital get this for those damned INR draws? Will you be able to sleep thru the 7am blood draws with this?
http://www.mdlinx.com/internal-medicine/product-center/medical-device-description.cfm/8922/?featured=no 

New device reduces risks, anxiety associated with blood draws

Velano Vascular —Visit Website

The FDA has granted clearance to a modified version of Velano Vascular’s novel, needle-free blood draw device, which is designed to reduce blood draw-related discomfort and anxiety for hospital inpatients, provide a safer work environment for healthcare providers, and standardize today’s fragmented approaches to inpatient blood draws. This second FDA clearance of the device includes two modifications designed to enhance the product’s usability for inpatient blood draws, one of the most common medical procedures performed today: The addition of a clamp for use with syringe draws, a frequent practice in pediatric patients, and a refinement to the Indication for Use (IFU). The Velano device is attached to a peripheral IV catheter to draw blood directly into a vacuum tube or a syringe; the revised IFU removes a limitation in the earlier clearance that specified when the device could be used with in-dwelling peripheral IV catheters. Roughly 760 inpatient blood draws are conducted every minute in the United States alone. Despite their ubiquity, blood draws create tremendous disruption for patients and clinicians alike, and are associated with significant direct and indirect costs. Twenty-eight percent of adult venipunctures and 44 percent of pediatric venipunctures require more than one stick to successfully draw blood, and around 10 percent of children aged 3 to 10 years old must be physically restrained to endure a needle-based blood draw. Published data suggest that U.S. healthcare professionals endure an average of 200 needle-related injuries each day. Aside from the significant physical and emotional toll of these injuries and any related seroconversion, studies suggest that accidental needle sticks cost hospitals upwards of $50 million per year.

DARPA Takes A Stab At Needle-Free Blood Draws

This would be so great for our INR testing needs. Then I wouldn't have to be woken up at 7am in the hospital for the vampires to take a sample of my blood. But I bet your hospital will not be using this for 40 years.
http://www.forbes.com/sites/robertszczerba/2015/05/13/darpa-takes-a-stab-at-needle-free-blood-draws/